| Objective To investigate the application of 3D printing combined guide plate technology in the placement of hollow nails for medial malleolus fracture. Methods From June 2017 to April 2018, 23 patients with medial malleolus fracture were treated with hollow nail implantation assisted by 3D printing combined guide plate technology. Among them, there were 12 males and 11 females, aged from 23 to 85 years, with an average age of 52.6 years. There were 17 cases of supination-extroversion type, 1 case of supination-adduction type and 5 cases of supination-extroversion type. The data of CT scan of ankle joint before operation were collected, and the three-dimensional model of fracture was synthesized and printed by importing software. The reduction of medial malleolus fracture, safe insertion point and working channel of hollow nail were simulated by computer, and the guide plate for inserting nail was designed. The time of cannulated screw placement (from the time of incision to the time of the end of two cannulated screw placement) and fluoroscopy times were analyzed during the operation. The reduction was evaluated by Burwell-Charnley fracture reduction radiological evaluation criteria and the ankle function was evaluated by Kofoed score criteria. Results A total of 46 hollow screws were implanted in 23 patients with medial malleolus fracture. The time of screw implantation was 7-15 min, with an average of 10.7 min. The fluoroscopy of hollow screw for medial malleolus was performed once during the operation. According to Burwell-Charnley criteria, 21 cases were excellent and 2 cases were good. The excellent and good rate was 100%. Postoperative Kofoed score was used to evaluate the ankle function of the patients. 15 cases were excellent, 7 cases were good and 1 case passed. The excellent and good rate was 95.6%. Conclusion The application of 3D printing combined guide plate technology is more conducive to young doctors' accurate internal fixation operation, shorten their learning curve, improve the accuracy of operation, may reduce the number of invalid nails, thus reducing the number of fluoroscopy, shorten the operation time, reduce intraoperative bleeding, and has the advantages of minimally invasive, reducing radiation exposure. |
